Mechanical Ventilator Weaning

3 Pages 685 Words

The research article I found contained information about ventilator weaning outcomes in infants and children. The research design was quantitative, using a randomized controlled trial. The sample consisted of one hundred eighty-two spontaneously breathing children less than eighteen years old, who had been receiving ventilator support for more than 24 hours and who failed a test for extubation readiness on minimal pressure support. The research was conducted in the pediatric intensive care units of 10 children’s hospitals across North America from November 1999 through April 2001.
The Purpose of this research was to evaluate whether weaning protocols are more effective than standard care with no defined protocol and whether a volume support weaning protocol using continuous automated adjustment of pressure support by the ventilator (VSV) is more effective than manual adjustment of pressure support by clinicians. The measurements used to verify extubation readiness included “checking for spontaneous respiratory effort, having a gag reflex or cough with suctioning, pH of 7.32 to 7.47 on most recent blood gas analysis, positive end expiratory pressure (PEEP) of 7 cm H2o or lower, and fraction of inspired oxygen (Floz) of 0.6 or less” (Randolph,et al,pg.3). The extubation readiness test (ERT) consisted of changing the F2 to 0.5 and decreasing PEEP to 5cm H20. With both setting adjustments, the spo2 had to stay above 95%. This was measured using a pulse oximetry reading. The patients unable to maintain spo2 of 95% or greater were removed from the test. Those who did maintain spo2 at 95%v or above had their ventilator mode changed to PSV and were placed on minimal PSV. Exhaled tidal volumes were measured at the ETT using a CO2SMO Plus monitor with sensors. (Novametrix Medical Systems, Inc.) I think the measurements that were used in the study are reliable and effective. It is appropriate to monitor spo2 levels and exhaled tidal volumes...